Many of the burns Brad Freeman, MD, Barnes-Jewish Hospital burn, trauma, critical care surgeon sees during the winter months could be avoided if folks would take a few extra seconds to use some good old common sense.

"Most of the injuries we see are from a total lack of judgment," Dr. Freeman says. "I think for burns, particularly outside of the industrial setting, most are the result of carelessness."

Dr. Freeman typically sees patients with the same types of burns every winter:

• injuries because of splashing grease from a stove top or deep-fat fryer
• injuries due to a faulty space heater or kerosene heater
• flash burns from opening a vehicle''s radiator cap
• burns due to a portable oxygen tank exploding

The burns Dr. Freeman sees from splashing grease include injuries to the face, torso and even feet. He says using a little common sense such as wearing shoes while frying chicken or dipping a turkey into a deep-fat fryer could avoid trauma to the feet.

"Another thing you hear about this time of the year are kids in the kitchen and hot grease being spilled on them," Dr. Freeman says. "For a child, those can be very severe burns because, typically, they''re third-degree burns and they can involve a fairly large surface area of a child''s body."

Kerosene and/or space heaters can be dangerous this time of year for a number of different reasons. Dr. Freeman says electric space heater fires can be caused by faulty wiring in older units; accidentally covering the cord with a throw rug or blanket, causing the cord to get overheated; or simply forgetting to turn a heater off.

"Kerosene heaters are always potentially dangerous because some of them aren''t in the greatest of shape," Dr. Freeman says. "People are sometimes careless with the way they handle the combustible fluid. Probably at least two or three times a winter season we''ll see a major house or apartment fire that was caused by a kerosene space heater."

Flash burns also are common this time of the year. The stress Old Man Winter puts on vehicles can cause them to overheat. Dr. Freeman sees patients with flash burns to the face and hands from opening a radiator cap. He says the hot antifreeze spews from the radiator much like soda does when a 2-liter bottle is shaken before it''s opened.

"Again, that sounds like a fairly common-sense thing, but probably an average of once a month, we''ll see somebody with first- or second-degree burns to the face and upper torso from opening a radiator cap," Dr. Freeman says. "It''s particularly problematic because some patients come in with significant corneal injuries.

"It seems to me that if your car is overheating, you don''t want to get in there and unscrew the cap. Maybe the thinking is, you unscrew the cap and then fill it with antifreeze. This is a health hazard. You should wait until the car cools down to open the radiator cap."

And for people using supplemental oxygen, Dr. Freeman says the individual using the oxygen, as well as family or friends, shouldn''t smoke anywhere near the tank.

"Oxygen is very combustible," Dr. Freeman says. "Some of the patients are frail to begin with and if you superimpose them with burns or inhalational injuries, it could be quite morbid."

(story by Brian Bretsch, originally printed in January 13, 2003 edition of BJC Today.)